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- ��_ CITY OF DIAMOND BAR
� � DEPARTMENT OF COMMUNITY&DEVELOPMENT SERVICES 'i
_;,,_� 21825 Copley Drive,Diamond Bar,CA 91765
(909)839-7020 Fax(909)861-3117 Building Inspection Hotline(909)839-7027 PRESS
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w TURE.PRIOR TO ITS ISSUANCE,ALSO RE�UIRES THE APPLICANT FOR SUCH PERMI7 TO FILE A SIGNED w Patio/Deck
� STA7EMENT 7HAT HE OR SHE IS LICENSED PURSUAN7 70 THE PROVISIONS OF THE CANTMCTORS LI- �
� CENSE UW(CHAPTER 9(COMMENCING WITH SECTION 7000)OF DIVISION 3 OF TFiE BUSINESS AND PRO� POOVSPB
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� A CIVIL PENALTY OF NO7 MORE THAN FIVE HUNDRED DOLURS(SSao).):
Z ❑I,ASOWNEROFTHEPROPERTV,ORMVEMPLOYEESWITHWAGESASTHEIRSOLECAMPENSATION, � COmm0fCl81
WILL DO THE WORK,AND THE STRUCTURE IS NOT INTENDED OP OFFERED FOR SALE(SEC.70��,BUSI� J
� NESS AND PROFESSIONS CAOE:THE CANTRAC70RS IICENSE LAW DOES NO7 APPLV TO AN OWNER OF ?
PpOPER7Y WHO BUILDS OR IMPROVES THEREON,AND WHO DOES SUCH WORK HIMSELF OR HERSELF OR
Q THROUGH HIS OR HER OWN EMPLOVEES,PROVIDED THA7 SUCH IMPROVEMENTS ARE NOT IN7ENDED OR m
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Z TION,THE OWNER�BUILDER WILL HAVE THE BURDEN OF PROVING THA7 HE OR SHE DID NOT BUIID OR
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Q TO CONSTRUCT THE PRQIECT(SEC.7044,BUSINESS AND PROFESSIONS CODE:THE CONTRACTORS LI� V8W8�10� ADJ.AREA
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� I HEREBY AFFIRM UNDER PENALTV OF PERJUFY THAT I AM LICENSED UNDER PROVISIONS OF CHAPTER �
d e(COMMENCING WITH SECTION 7000)OF DIVISION 30f THE BUSINESS AND PROFESSIONS CODE,AND Z
MV LICENSE IS IN FULL FORCE AN�EFFECT. 5 /'
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� WORKERS'COMPENSATION DECLARATION a
� I HEREBV AFFIRM UNDER VENALTY OF PERIURV ONE OF THE FOLLOWING DECUFATIONS: Z .
� _IHAVEANDWILLMAINTAINACERTIFICATEOFCONSENTTOSELF�INSUREFORWORKERS' _
COMPENSATION,AS PROVI�ED BY SECTION 3700 OF THE LABOR CODE,FOF THE PERFORMANCE U
Q THE WORK FOfl WHICH THIS PERMIT IS ISSUED. �
w � 1 HAVE AND WILL MAINTAIN WORK RS'COMPENSATION INSURANCE,AS REQUIRED BV SECTION
Q 3700 OF THE LABOR CODE,FO �E PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS
ISSUED.MY 5'CAMP SATION INSURAyEE CARRIER AND POLICV NUMBER ARE: CONSTRUCTION
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Z I CERTIFY THAT IN THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED,I MECHANICAL
L}' SHAIL NOT EMPLOV ANY PERSON IN ANV MANNER 50 AS TO BECOME SUBJECT TO THE
(/� WORNERS'COMPENSATIONLAWSOFCALIFORNIA,ANDAGREETHATIFISHOULDBECOME INSPECTIONFEE
= SU&IECT TO THE WORKERS'COMPENSA710N PROVISIONS OF SECTb N 3700 OF THE LABOR �cO�
CO�E.I S ALL FOR WITH COMPLV WITH THOSE PR VI o . AN ��
� SMIP
p DATE: PLICANT.
J WARNING FAILURE TO SECURE WORKERS'COM NSATION � RAGE IS UNLAWFUL,AND SHALLBE ENERGY P/C
� $UBJECTANEMPLOVERTOCRIMINALPENALTIESAN�CIVILFWESUPTOONEHUNDREDTHOUSAND ENERGYPERMIT
DOLLARS(f10o.o00).IN ADDI710N TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN
� SECTION 3708 OF THE LABOR CODE.INTEREST,AND ATfORNEY'S FEES. ENTION FEE: / O
OCONSTRUCTION LENDING AGENCY PRE-ALT FEE:
� I HEREBV AFFIRM UNDER PENAL7V OF PERJURY THAT 7HERE IS A CONSTRUCTION LENDING AGENCY
FOR THE PERFORMANCE OF 7FIE WORK FOR WHICH THIS PERMIT IS ISSUED(SEC.3oB7,CIV.C.). .
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� LENDER'S NAME
F— LENDER'SADDRESS
� TOTAL FEES �ij �SO
� I CERTIFY THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE INFORMATION IS CARRECT.
w I AGREE TO COMPLV WITH ALL CIN AND COUNTV ORDINANCES AND STATE LAWS RELATING TO BUILDING
� CANSTRUCTION,AND HEREBV AU7HORIZE REPRESENTATIVES OF 7HI5 COUNN 70 EN7ER UPON 7HE
� ABOVE�M 710NEDGROPERTVFORINSPEC71 PURPOSES.
Z COMMENTS
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� SIGNATUREO EE DA7E
= RECPT.NO. PAID BY VALIDATION
~ WHITE—Department Copy,YELLOW�inance Copy,PINK—Assessor CoDY.GOLDENROD—File Copy,GREEN—Applicant's Copy
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SET BACK FLOOR JOIST �
FTGS/FORMS/STEEL FHA REQMTS
ELECTRIC GROUND UNDER FLOOR DUCT
GROUND PLUMBING UNDER FLOOR CONDUIT
SLAB GRADE FIREPLACE FOUNDATION
TEMP POWER FIREPLACE BOND BEAM
WATER SERVICE MIO H'T. BOND BEAM
ROOF SHEATHING 8 FT. BOND BEAM
FRAMINGNENTILATION FINAL BOND BEAM
ROOF COVER PRE-GRADING
ROUGH HEATING BENCHING
ROUGH ELECTRIC ROUGH GRADING
ROUGH PLUMBING FINISH GRADING
SHOWERlTUB TEST POOL ELECTRIC
� EXT.LATH/SIDING POOL FENCING
WALL INSULATION i POOL FINAL
CEILING INSULATION OFF SITE IMPS.
DRYWALL NAILING DEDICATIONS
SEWER FINAL ENG.
SEPTIC TANK LANDSCAPE/IRRIG.
SEEP PIT/L.L. � ON SITE IMPS.
GAS AIR TEST FINAL ZONING
FINAL CONST. FIRE DEPT. FINAL
FINAL HEATING HEALTH DEPT. FINAL
FINAL ELECTRIC DEV. FEES PAID I
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FINAL PLUMBING ENERGY
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COMMEfVTS
SEPTIC TANK SIZE
SEEP PIT/U SIZE
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` � CITY OF DIAMOND BAR
,r,. Community Development Department
� � � � 21825 Copley Drive•Diamond Bar,CA 91765
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�;-:� -�. Building Inspection Request Hotline
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(909)839-7027
Building , Planning � Engineering
(909)839-7020 (909)839-7030 (909)839-7040
CORRECTION NOTICE
PERMIT N � ��� DATE: � � TIME: � � a.�_
C CTO /yn► ��/� Y V`��uVv�-C�I._
OWNER BUILDER �•-���' �'1
ADDRESS (Pro'ect Site)
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❑PLEASE CONTACT THE UNDERSIGNED �
�SE MAKE CORRECTIONS AND CALL FOR REINSPECTION
❑REINSPECTION FEE REQUIRED
❑PLEASE MAKE CORRECTIONS AND P OCEED WIT WORK
INSPECTOR: � � � Y �
(print namc) �
SIGNATURE OF INSPECTOR:
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